Value of common surgeries being reconsidered

In a development that is significantly changing the medical landscape, research is calling into question the value of a wide variety of common surgeries. Thanks to this research and advanced technology – as well as concern about higher health costs – doctors are telling many patients not to go under the knife for conditions that were once routinely treated that way.

The move away from surgery is being spurred in part by such technology as better ultrasounds and CT scans that let doctors monitor a patient more closely without opening them up.

A growing number of studies show that patients who don't get surgery often fare just as well, if not better, than those who do, due to side effects and complications of treatment.

Health-care insurers that have been putting stiff pressure on doctors to offer less costly care, are beginning to factor this new research into their policies.

Health plans in general are moving away from requiring patients and doctors to get pre-approval for all surgeries.

Instead, some are starting to create lists of procedures that need prior authorisation – these are typically operations that science suggests are performed too frequently, such as hysterectomies or surgery for lower back pain.

Doctors may be more willing to try alternatives to these surgeries if they know it will be a struggle to get reimbursed.

What is different about the current movement is that it is being driven primarily by the surgeons: the one group that seemingly has the biggest incentive to operate. “Radical surgery is a thing of the past," says Richard Andrassy, chairman and professor of surgery at the University of Texas Medical School in Houston.

Source: Amy Dockser Marcus, New Research Questions Need For Some Common Surgeries, Wall Street Journal, April 22, 2003.

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FMF Policy Bulletin, 29 April 2003